Which of the following statements about nonparticipating providers is accurate?

Prepare for your Revenue Cycle and Billing exam with our comprehensive test. Utilize flashcards and multiple choice questions, complete with hints and detailed explanations to succeed!

Nonparticipating providers have the flexibility to set their own fees for services rendered to patients. This means that they can charge patients more than the Medicare-approved amount. When a nonparticipating provider sees a Medicare patient, they can bill for their services above the Medicare fee schedule, which may result in additional out-of-pocket costs for the patient.

It's important to note that although nonparticipating providers are not obligated to accept Medicare's assignment (the agreed-upon amount for services), many still do so for convenience. However, when they do choose to not accept assignment, the patient is responsible for paying the difference between what Medicare reimburses and what the provider charges. This characteristic of charging extra fees highlights the unique billing practices that nonparticipating providers can employ compared to participating providers, who agree to accept the Medicare-approved amount as payment in full for their services.

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